Sound policies for protecting coastal communities and assets require good information about vulnerability to flooding. Here, we investigate the influence of sea level rise on expected storm surge-driven water levels and their frequencies along the contiguous United States. We use model output for global temperature changes, a semi-empirical model of global sea level rise, and long-term records from 55 nationally distributed tidal gauges to develop sea level rise projections at each gauge location. We employ more detailed records over the period 1979–2008 from the same gauges to elicit historic patterns of extreme high water events, and combine these statistics with anticipated relative sea level rise to project changing local extremes through 2050. We find that substantial changes in the frequency of what are now considered extreme water levels may occur even at locations with relatively slow local sea level rise, when the difference in height between presently common and rare water levels is small. We estimate that, by mid-century, some locations may experience high water levels annually that would qualify today as 'century' (i.e., having a chance of occurrence of 1% annually) extremes. Today's century levels become 'decade' (having a chance of 10% annually) or more frequent events at about a third of the study gauges, and the majority of locations see substantially higher frequency of previously rare storm-driven water heights in the future. These results add support to the need for policy approaches that consider the non-stationarity of extreme events when evaluating risks of adverse climate impacts.